TY - JOUR
T1 - Do patients in a medical or surgical ICU benefit from a neurologic consultation?
AU - Mittal, Manoj K.
AU - Kashyap, Rahul
AU - Herasevich, Vitaly
AU - Rabinstein, Alejandro A.
AU - Wijdicks, Eelco F.M.
N1 - Publisher Copyright:
© 2014 Taylor and Francis.
PY - 2015/7/3
Y1 - 2015/7/3
N2 - Neurological complications are common in general medical and surgical intensive care units (ICU); they can prolong ICU and hospital stay and worsen outcome, including mortality. We performed a descriptive analysis of neurological consultations in non-neurological ICUs to determine the frequency of various neurological complications and to assess the diagnostic yield, therapeutic implications and prognostic benefit of these consultations. This is a retrospective single group cohort study of all neurological consultations for patients admitted to non-neurological (medical, respiratory care unit, cardiac, cardiothoracic, surgical and trauma) ICUs at Saint Marys Hospital (Mayo Clinic, Rochester) over a 24-month period (01 January 2010 to 31 December 2011). Equal numbers of neurological consultations (174, 50% each) were requested from medical ICUs and surgical ICUs. Altered consciousness (158, 45%), seizure (76, 22%) and focal deficits (75, 22%) were the most common reasons for consultations. Diagnostic, prognostic and therapeutic benefit was considered present in 89%, 38% and 39% patients respectively. Treatment change following neurological consultation occurred in 48% patients. Encephalopathy, stroke, seizure and anoxic brain injury were the most common causes of neurological complications in non-neurological ICUs with sedatives and opiates being the most common cause of encephalopathy. Almost half of the patients had change in treatment following neurological consultation. Neurological consultations in non-neurological ICU's are beneficial for patient's care in terms of diagnosis, treatment and prognosis.
AB - Neurological complications are common in general medical and surgical intensive care units (ICU); they can prolong ICU and hospital stay and worsen outcome, including mortality. We performed a descriptive analysis of neurological consultations in non-neurological ICUs to determine the frequency of various neurological complications and to assess the diagnostic yield, therapeutic implications and prognostic benefit of these consultations. This is a retrospective single group cohort study of all neurological consultations for patients admitted to non-neurological (medical, respiratory care unit, cardiac, cardiothoracic, surgical and trauma) ICUs at Saint Marys Hospital (Mayo Clinic, Rochester) over a 24-month period (01 January 2010 to 31 December 2011). Equal numbers of neurological consultations (174, 50% each) were requested from medical ICUs and surgical ICUs. Altered consciousness (158, 45%), seizure (76, 22%) and focal deficits (75, 22%) were the most common reasons for consultations. Diagnostic, prognostic and therapeutic benefit was considered present in 89%, 38% and 39% patients respectively. Treatment change following neurological consultation occurred in 48% patients. Encephalopathy, stroke, seizure and anoxic brain injury were the most common causes of neurological complications in non-neurological ICUs with sedatives and opiates being the most common cause of encephalopathy. Almost half of the patients had change in treatment following neurological consultation. Neurological consultations in non-neurological ICU's are beneficial for patient's care in terms of diagnosis, treatment and prognosis.
KW - Neurology
KW - benefit
KW - consultation
KW - intensive care unit
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U2 - 10.3109/00207454.2014.950374
DO - 10.3109/00207454.2014.950374
M3 - Article
C2 - 25182690
AN - SCOPUS:84938683056
SN - 0020-7454
VL - 125
SP - 512
EP - 520
JO - International Journal of Neuroscience
JF - International Journal of Neuroscience
IS - 7
ER -